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Clerkship Course Description

The Emergency Medicine core rotation is designed to introduce students to the principles of acute care medicine. Students have the opportunity to evaluate patients as well as formulate effective testing and treatment strategies. Active participation in patient care and procedural skills are emphasized. The course consists of experiences in patient care, assigned readings from emergency medicine references, weekly conferences and a final exam at the end of the rotation. Detailed information and schedules can be viewed at the Clerkship website.

Course Director
Wirachin Hoonpongsimanont, MD
whoonpon@uci.edu
714-456-5239

Assistant Course Director
Alisa Wray, MD
awray@uci.edu
714-456-7916

Long Beach VA Program Director
David Barry, MD
jdavebarry@gmail.com or james.barry5@va.gov
562-900-6233

Extramural & UCI 630D Course Coordinator
Jessica Holland
jmhollan@uci.edu
714-456-8116

547 UCI Course Coordinator
Sun Ito
slito@uci.edu
714-456-5176

Instructing Faculty

All faculty members in the Department of Emergency Medicine provide 24 hour teaching and supervision of medical students.

Applications »


To apply for an externship position, please log onto the Visiting Students Application Service (VSAS). If your school does not participate in VSAS, unfortunately we are unable to accommodate you at this time.

Our Emergency Medicine rotation is in high demand at the beginning of the academic year (May to November). We encourage you to contact us at least three (3) months prior to your preferred start date because our clerkship tends to fill up far in advance.

Please do not hesitate to contact our coordinator, Jessica Holland (jmhollan@uci.edu), at any time for possible openings due to cancellations. Please note that between May and November, we generally only accept students who are planning to apply to our emergency medicine residency program. 

To apply:

U.S. Applicants

  • Apply to the UC Irvine School of Medicine's Student Affairs office using the AAMC's VSAS. 
  • Students who wish to rotate between May and October must email our clerkship coordinator, Jessica Holland (jmhollan@uci.edu) and cc: Dr. Hoon (whoonpon@uci.edu) with the following information:
    • Your top three preferred start dates (in order of preference). 
    • Your curriculum vitae, including your USMLE Step 1 score and Core Clerkship grades.
    • The name and email address of your EM faculty advisor/mentor, or a faculty mentor who knows your career choice and can verify your goals and plans.

International Applicants

International students must be enrolled in a medical school that has a Memorandum of Understanding (MOU) with the UC Irvine School of Medicine. Send your application to Thasin Sultan (sultant@uci.edu), our curricular affairs coordinator.

Objectives »


Students learn to conduct thorough but directed histories and physicals, as well as to formulate a plan for workup and care of each patient they see.

Procedural skills, such as suturing, paracentesis etc., are taught and supervised on a case-by-case base as needed, depending on the patient’s complaints and need for evaluation.

All students are expected to introduce themselves as student physicians and to conduct themselves in a professional manner. These expectations are set out at student orientation.

By the fourth year of school, students already should be meeting these expectations. Students interact one-on-one with residents and faculty members who monitor their progress during each shift.

Key skills:

  • Take a directed patient history and perform a complete physical examination
  • Formulate plan of workup and treatment
  • Present cases directly to the senior resident and attending physicians
  • Learn techniques to improve suturing skills
  • Follow patients from initial exam through discharge from the emergency department

Competencies:

  • The ability to competently conduct a medical interview and counseling to take into account patient health beliefs, patient agenda and the need for comprehensive medical and psychosocial assessment
  • The ability to competently perform a complete and organ-system-specific examination including a mental health status examination
  • The ability to articulate a cogent, accurate assessment and plan, and problem list, using diagnostic clinical reasoning skills in all the major disciplines
  • The ability to search the medical literature, including electronic databases, and to locate and interpret up-to-date evidence to optimize patient care
  • The ability to practice effective preventive medicine by identifying, addressing and advocating for strategies to maintain health and wellbeing, to identify and treat disease early where appropriate and to advise on lifestyle practices
  • The ability to function effectively within the context of complexity and uncertainty in medical care
Attitudes and commitments:
  • Honesty and integrity reflecting the standards of the profession, in interacting with ul colleagues, patients, families and professional organizations
  • Professional behaviors reflecting compassion and respect for patient privacy, altruism and a commitment to comprehensive, holistic medical care
  • Sensitivity and awareness of diverse cultures, health beliefs and social factors impacting patient health and illness
  • The commitment to seek knowledge and skills to better serve the needs of the underserved in their communities

Content Theme Integration

  • Communication
  • Decision-making
  • Ethics
  • Family violence/abuse
  • Geriatrics
  • Healthcare systems
  • Pain management
  • Patient health education
  • Preventive and health maintenance
  • Substance abuse

Educational Activities

  • Orientation
  • ED Onsite Orientation
  • Hand hygiene and fall prevention videos
  • Resident Conference OR SIM
  • Education Sessions/Flipped Classrooms
  • iTunes Assignment
  • Patient Case Diagnosis Logs
  • Procedure Logs
  • Shift Attendance/Evaluations
  • Communications Assessment Tool
  • Medical Student Documentation Checklist [H&P]
  • Journal Club [Optional]
  • NBME [630D UCI Students ONLY]
  • Honors Case Presentation [Optional]
  • Acute care patient management
Scheduling »

Students on rotations with direct patient care, such as emergency medicine, work the exact schedule the team works. Therefore, anyone who does not want to be on call the night before a specific holiday, or on a specific holiday, should make sure to not schedule an emergency medicine rotation during that time. Please note that vouchers for days off are not valid for EM rotations.
Approximately two(2) weeks before the start of rotation, clerkship students receive an email from the clerkship coordinator detailing their schedules. All students must complete four(4)day and four(4) night shifts. 

Shift swaps are allowed if both parties approve [and it does not violate duty hours]. The swap request must be e-mailed to the coordinator and director at least two days in advance and is subject to approval. 

If a conflict occurs midway through a scheduled rotation, shifts can be swapped with another student. But the change must be made on the schedule. The attendings have access to this schedule from any computer and expect the students to adhere to this.

Before you miss a shift for medical reasons please call the attending physician on duty at 714-456-5705 [in addition to emailing the clerkship coordinator and director of your absence]. All absences will be documented and grades will be withheld until the absence is made up. 

Rotations »

Clerkship students are expected to familiarize themselves with the CANVAS website, orientation packet and course syllabus. Orientation is held on the first Monday of the rotation at 8 a.m., followed immediately after by Art of Medicine.

FIRST DAY [Frist Monday from 8a-noon]:
Orientation is held on the first Monday of the rotation at 8 a.m., in City Tower: 333 City Blvd. West, Suite 640, Orange, CA 92868 and is immediately followed by:
Onsite Orientation [9-10a]
Task Training [10a-12p]

FIRST SHIFT:
Check your schedule and report to the attending physician in the Emergency Department. 
You can usually track them down in the Resident Workroom
If the attending on your schedule has swapped out, please join the new faculty attending on same shift

ON-SHIFT ACTIVITIES/WORKFLOW: 
Log into Quest and assign yourself the patient with the red-boxed column. Type your name in medical student column when you initially pick up the patient note the vital signs.

Inform the attending before seeing the patient.
Example: "Hey Dr. Wray, I see a patient with Chest Pain, can I assign them to myself?" 

Students will work under the direct supervision of EM attendings. It is intended that the students participate actively in the evaluation and management of patient cases assuming more responsibility as their level of comfort and expertise develops. Students are not to be observers on this rotation. There are no minimum or maximum numbers of patients to be seen in a typical clinical session. This should be determined by the student's abilities, time, and their supervising physician.

IMPORTANT: 
If at any point, you identify an unstable patient, either from the board or at the bedside, immediately notify the senior resident (R3 or R2) or an attending.

Please introduce yourself to the patient as a fourth-year medical student. Always address your history and physical so that it is focused on the patient’s chief complaint. After completing the initial assessment of your patient, type your medical documentation into patient chart in medical student documentation note on Quest then present the case with the attending to formulate a plan. The presentation should take about 3-5 minutes. Once attending approves the plan, you can inform the nurse assigned to the patient of this plan. Do not order tests or administer medications without first discussing the plan with the attending. If at any time, you feel that a patient is very sick, or you do not feel comfortable managing a patient, please let the senior resident (R3 or R2) or attending know right away.

Student should see the patient, complete the medical documentation in QUEST, print out medical documentation, and immediately present the documentation to the attending on shift.

Reassess your patient periodically and give updates on care frequently. Note any change in your patient's condition and inform your attending immediately. You should not take on more than two acute ongoing patients at a time, unless approved by the attending.

If any consultants are called, note the name of the consultant, their department, beeper number and the time they were called. You are expected to consult the other specialties or perform the hand-off of patients to admitting team.

PATIENT SIGN-OUTS:
Patient sign outs from the medical student go directly to the attending and not to the incoming student.

ASSIGNED SHIFTS: 
Satisfactory completion of shifts is required to pass the rotation and prompt attendance is required.

Approximately 2 hours before the end of each shift, students must request the attending to complete end-of-shift evaluation form, as this will be how students’ shifts are recorded. The attending needs to complete, sign, date, through the QUALTRICS link on the ED link on Quest before student leave the ED. The student is required to have 8 evaluations at the end of his/her rotations to meet the requirement of the course (15 for 630D students).

Students must also hand out a Communications Assessment Tool sheet [and have it collected by an attending] to at least one patient per shift. The attending should give this to you before your shifts ends and you should be submitting it with the rest of your paperwork at the end of the rotation [8 for 547 students; 16 for 630D students].

Each shift you are expected to print an H&P checklist and one of your charts from that day and present them to your attending to review with you to help you improve your medical documentation, clinical reasoning and decision making skills. Staple your chart and H&P checklist together and turn them into Dr Hoon’s mailbox in the ED workroom.

SCHEDULE CHANGES:
As stated above, students may exchange shifts with peers. However, please keep the following in mind when considering schedule changes:
All educational sessions require attendance by students.
Students cannot take more than one shift a day and cannot follow an evening shift with a morning shift.
Shift change requests need to be e-mailed to the clerkship coordinator and are subject to approval. 

PATIENT SIGN-OUTS:
Patient sign outs from the medical student go directly to the R3 and not to the incoming student.

ROLES AND RESPONSIBILITIES:
Students are expected to attend/arrive on time to all mandatory activities: orientation, onsite orientation, task training, all assigned shifts, Wednesday conferences/SIM Sessions/MS SIM Sessions, Flipped Classrooms, and TBLs.
Students are expected to complete all assigned case logs, procedures logs, alternative tasks, evaluations, and department exercises.
Emergency medicine is the practice of medicine in an acute and sub-acute setting. The emergency physician’s role is to assess; treat, admit, or discharge any patient that seeks medical attention at any time of day or night.
It is the emergency physician’s job to take a full history, perform a physical exam, and obtain the tests that will elucidate the cause of the patient’s complaint. Upon doing so, the physician must either treat the patient or refer him/her to the appropriate follow up care. A trained emergency physician is able to handle not only traumas, but also almost every other imaginable acute and non-acute problem. Because most hospital admissions come through the Emergency Department (ED), it is imperative that the Emergency Medicine (EM) physician have a good grasp of most fields of medicine.
The ED is an extremely exciting and vibrant setting. One patient may have a laceration or broken bone while in the next bed over, a patient may be suffering an acute MI. Because of this variety, the Emergency Physician receives training in a wide diversity of procedures (central lines, lumbar punctures, chest tubes, ultrasound, etc.). This training and ability is what keeps the scope of practice lively and ever-changing. 

Journal Club »

Journal Club is usually held on the third Thursday of each month from 6 to 10 p.m. Attendance is encouraged for all students.

The location varies and is usually held at the house of an ED attending or resident. You are excused from your shift to attend Journal Club, but must return to your shift as soon as it has ended.

If you are interested in attending please RSVP, so the clerkship coordinator can prepare a packet of articles to read. You will need to have read the articles prior to attending Journal Club. 

EM Conference and Simulation Center »

Grand Rounds Conference/Simulation Sessions [Wednesdays, 9a-12p]

Grand Rounds Conference Schedule

All students [including those at Long Beach VA] are required to attend the weekly [Wednesday] conferences/SIM sessions held at:

  • Conference: City Tower - 333 City Boulevard West, Suite 640, Orange, CA 92868
  • Sim Center: Irvine Campus - Building 836 Simulation Center, Health Sciences Road, 2nd Floor
  • Team-Based Learning/Education Sessions [immediately follows Wednesday Joint Conference/SIM]

All Students have an additional Medical Student [specific] Simulation Session with Drs. Kimberly Sokol and Eric McCoy. This is separate from the Join Resident Simulation Session mentioned above and usually runs from 8a-noon.

Education Sessions: Tasking Trainings and Flipped Classrooms »

A special medical student lecture, the "Flipped Classroom," will be given immediately after Conference/Sim Center, from 11:30 a.m. to 12:30 p.m.

During the “classroom,” clerkship students have a case discussion with an EM faculty member.

Here is a weekly summary of course hours:

Week Time Subject
Week 1 10a - 12p Task Training
Week 1 12 - 1p TBL: Approach to Shock
Week 1 1 - 2p Flipped Classroom: Chest Pain
Week 2 12 - 1p TBL: Altered Mental Status
Week 2 1 - 2p Flipped Classroom: General & Lower Abdominal Pain

Week 3

(630D Students)

730 - 9a

Task Training: Intubation & Ventilation Management

(Optional  for all students, but highly encourage for 630D students)

Week 4

(630D Students)

730 - 9a

Task Training: EKG & Radiology Interpretation

(Optional  for all students, but highly encourage for 630D students)